(1716) Nerve-Racking: Exploring the Effects of TBI on Cranial Nerve Injury

Introduction: Traumatic brain injuries (TBI) are a significant and growing health issue, leading to over 200,000 hospitalizations annually in the United States. Cranial nerve (CN) injuries accompanying TBI can severely impact patients’ quality of life. This review aims to address the gap in research regarding the severity, mechanisms of injury, and associated intracranial injuries, emphasizing early detection and intervention.

Methods: A comprehensive literature search was conducted across databases such as PubMed and Ovid using key terms including “cranial nerve injury,” “cranial nerve palsy,” “traumatic brain injury,” and “Glasgow Coma Scale.” Inclusion criteria encompassed studies reporting CN injuries with TBI, categorized by Glasgow Coma Scale (GCS) scores, and the mechanisms of injury. A total of 21 studies were reviewed, integrating data from adult and pediatric populations.

Results: The incidence of CN injuries in TBI patients varies in the literature, with studies reporting rates between 5-23%. Data revealed significant occurrences of CN injuries in mild (GCS 13-15), moderate (GCS 9-12), and severe TBIs (GCS < 9). Common mechanisms of injury included automobile accidents, falls, and crush injuries in pediatric patients. Associated injuries included skull base fractures (38.9%), subdural hematomas (16.6%), epidural hematomas (18.9%), and subarachnoid hemorrhage (25.6%). Early detection and intervention were found to be critical in improving patient outcomes, with delays leading to increased disability and poor prognosis.

Conclusions: The classification of traumatic brain injuries via the Glasgow Coma Scale does not confirm the presence or absence of concomitant cranial nerve injury, as even mild head injuries can result in cranial nerve palsy. However, acknowledging common mechanisms of injury and associated intracranial injuries can elucidate the possibility of cranial nerve damage in order to facilitate early recognition and treatment.